All States/Territories

In June 2008, Tennessee passed legislation restructuring LTC service delivery, including the expansion of HCBS services by integrating LTC within a managed care environment and providing consumer direction options. In March 2010, the state implemented the CHOICES program, wherein persons enrolled in TennCare that needed LTC services would receive them through a managed care organization. Review a presentation given at the 2010 HCBS conference and the CHOICES website.

PSWH is a person-centered planning process that looks comprehensively at a person’s health life-style, focuses on a person’s strengths, interests and natural supports, stresses creating new health life-style habits and disciplines, and provides peer support delivered by peer specialists to promote self-directed whole health. Attached find a presentation given at the 2010 HCBS conference and an information sheet.

Care management has been recognized as a valuable service in supporting family members who care for their older adult relatives. TCARE® is a caregiver assessment and referral protocol designed to assist care managers. The major goal of TCARE® is to provide care managers with a set of steps that are needed to move from the assessment to the implementation of a care plan. Find a presentation on Georgia’s experience with their person-centered initiative and use of the protocol

States are developing comprehensive APS systems that include assessments, policies and procedures to assist staff in performing intakes, investigations, and case planning by providing a consistent approach to obtaining and evaluating information. The SDM® system is intended to promote the safety of vulnerable adults, identify and address their needs, decrease the incidence of self-neglect and maltreatment, enhance service delivery, and provide data for program administration.

The GQMS was developed to support continuous quality improvement to services delivered to individuals with intellectual disabilities in GA. The overall vision of the project was to enhance the service delivery system in order to produce results that reflect communicated choices and preferences that matter most to the individuals. The GQMS is based on CMS’ Quality Framework for Home and Community Based Services. Find their annual report and background information on the site.

NJ’s charge to advance a Medicaid LTC system where there would be more options for community care, greater consumer choice and allowance for maximum flexibility between nursing homes and HCBS is “definitely showing positive trend lines” according to this report. The state’s Global Budget Projection model offers a budgetary process for tracking and projecting its LTC expenditures. Explore detailed information about the model’s methodology and findings.

Families have always borne the burden of long-term care, and struggle with feelings of grief, loss, despair, anger and hopelessness. In this powerful first person account, the author points out some of the sad consequences of the American health care system's emphasis on the treatment of acute episodic illness or injury and its relative neglect of chronic illness long-term care. This essay, written for the New England Journal of Medicine’s “Sounding Board” series, is considered a seminal work.

Are you developing a participant handbook for your Veteran-Directed Home and Community Based Services program? Review state examples from Maine, Massachusetts, Texas, and Washington. These participant handbooks provide an overview of the VDHCBS program, the assessment process, developing a person-centered plan and individual budget, legal responsibilities as an employer, working with a Financial Management Services vendor, and more.

View a four-part series that comprehensively examines the physical, mental, emotional, and lifestyle adjustments associated with caregiving. The show underscores the urgent need for understanding the stressful relationships that can evolve and offers guidance on how to manage expectations, providing insight into what support is already in place.

These informal, person centered thinking tools, created by The Learning Community for Person Centered Practices and the Inclusion Movement, were developed by cancer survivors to help individuals find empowerment or a sense of control in their experience. The website offers a number of on-line tools and worksheets that could be useful to individuals with disabilities and those who support them. Workshops, coffee chats and consultation sessions are offered as a way to help people use the tools.